Should the existing science of teams be applied to fluid teams? An exploration of fluid team effectiveness within the context of healthcare simulation

Introduction

Fluid teams have become increasingly prevalent and necessary for modern-day issues, yet they differ from more traditional teams, on which much of the current teams literature is based. For example, fluid teams are often comprised of members from different disciplines or organizational divisions who do not have a shared history or future, as they come together to perform a critical, time-sensitive task, and then disband. For these reasons, the mechanisms through which they function and perform may differ from those of more traditional teams, and research is needed to better understand these differences.

Methods

To this end, this study utilized critical incident techniques and thematic analysis to examine fluid teams within healthcare, one of the primary contexts in which they are prevalent. Interdisciplinary faculty and students in the medical field who encounter fluid teams within simulation-based education were prompted to reflect on key factors that facilitate or hinder fluid team effectiveness.

Results

Primary themes extracted pertained to the conditions fluid teams operate within (e.g., high-stress), the behaviors and emergent states that contribute to their success (e.g., communication), and the KSAO's of value for members of fluid teams to possess (e.g., readiness). These themes were then compared to existing literature, yielding the identification of some similarities but also many important differences between fluid and traditional teams.

Discussion

A series of practical recommendations for how to promote fluid team effectiveness is then presented.

The development and validation of an Army team resilience measure

Given the demanding nature of its mission, the collective units of the Army, not just individual Soldiers, need to be able to withstand and adapt to a wide range of challenges. Therefore, it is important to be able to effectively assess resilience at the team-level and to understand the factors that can enable or diminish it. This article describes the development of a construct valid and psychometrically-sound measure of team resilience - the Team Resilience Scale (TRS). A theoretical framework of team resilience and related constructs is introduced. We then summarize the procedures for developing the TRS and related constructs, providing evidence of the content validity of the TRS. Finally, we assess the psychometric soundness and construct validity of the TRS in two Army field studies. Our analyses support the convergent validity of items and indicate that the measure can be used to examine three first-order dimensions of resilience (i.e., physical, affective, and cognitive) or as a single overall resilience composite. Results show the TRS was positively related to team performance in both samples and it co-varied with stressors and team actions. Practical recommendations for use of the measure and suggestions for future research are offered.

The Power of Peer Leaders: Exploring the Link between Peer Leadership Behaviors and Sustainable Work Outcomes

Most leadership studies primarily focus on formal leaders, often overlooking the influence of leaders within the team. While prior research has shown that peer leaders can have a beneficial impact on various team outcomes, it is yet unclear which peer leadership behaviors precisely foster a supportive and sustainable work environment. Building upon the recent identification of 10 peer leadership roles and 37 underlying functions, the current study aims to investigate the relationships between these peer leadership roles and functions and key outcomes (i.e., job satisfaction, team cohesion, team effectiveness, and OCB). A total of 31 organizational teams, comprising 182 employees from diverse sectors, participated in a quantitative survey. Employing multilevel modeling analysis, the findings demonstrated that each leadership role and nearly every function predicted at least one outcome, highlighting their significance within organizational teams. Additionally, Necessary Condition Analysis revealed that specific roles and functions were necessary for generating one or more outcomes. Finally, we found that most of the significant relationships remained consistent across teams, regardless of their size, tenure, or level of team identification. These findings refine our understanding of shared leadership and how peer leaders can create a sustainable workplace by fostering employee well-being and productivity in organizational teams.

The Psychometric Properties of Two Brief Measures of Teamwork in Sport

In the current study, the structural and external validity of data derived from two shorter versions of the Multidimensional Assessment of Teamwork in Sport (MATS) were examined using multilevel analyses. Evidence of model-data fit was shown for both a 5-factor model comprising 19 items (with subscales assessing teamwork preparation, execution, evaluation, adjustments, and management of team maintenance) and a single-factor model comprising five items (providing a global estimate of teamwork). In general, data from both versions were positively and significantly correlated with (and distinct from) athletes' perceptions of team cohesion, collective efficacy, performance satisfaction, enjoyment in their sport, and commitment to their team and their coaches' transformational leadership. The measures appear well suited to detect between-teams differences, as evidenced by intraclass correlation coefficients and acceptable reliability estimates of team-level scores. In summary, the 19-item Multidimensional Assessment of Teamwork in Sport-Short and five-item Multidimensional Assessment of Teamwork in Sport-Global provide conceptually and psychometrically sound questionnaires to briefly measure teamwork in sport.

Leader airtime management and team effectiveness in emergency management command and control (EMCC) teams

We investigated the relation between leader airtime management and team effectiveness in Emergency Management Command and Control (EMCC) teams. Leader airtime management concerns leaders' interventions to structure who shares information when using opening and closing statements to respectively stimulate or reduce information sharing. We coded leaders' airtime management statements across different meeting phases (structuring, information sharing, decision making) using video-recordings of 12 EMCC exercises involving two consecutive meetings each. Experts rated two components of team effectiveness: Team Situation Awareness (TSA) and Team Decision Making (TDM). We found that closing statements were more frequently used in the decision-making phase than in any other meeting phase. Also, leaders of teams with lower TSA used more opening statements in the decision-making phase of the first team meeting than leaders of teams with higher TSA. These results confirm the importance of the timing of leader airtime management for EMCC team effectiveness. Practitioner summary: We investigated leader airtime management and team effectiveness in EMCC teams. We video-coded 12 exercises; experts rated team effectiveness. In the decision-making phase, leaders use more closing statements, and leaders of less effective teams use more opening statements. Leaders are advised to adjust their airtime management to meeting phases.

Influence of the Team Effectiveness of Nursing Units on Nursing Care Left Undone and Nurse-Reported Quality of Care

The aim of this study was to identify the influence of nursing unit team effectiveness on nursing care left undone and nurse-reported quality of care. This was a cross-sectional study with a sample of 230 nurses working at general hospitals in South Korea. Data were collected in January 2023 using an online questionnaire. Nursing unit team effectiveness was measured, consisting of the following sub-scales: leadership of the head nurse, cohesion, job satisfaction, competency of nurses, work productivity, and coordination. Multiple regression analyses were used to assess relationships between nursing unit team effectiveness and nursing care left undone and nursing-reported quality of care. Among these sub-domains, the study found that the higher the coordination (β = -0.22, p < 0.001), the significantly lower the nursing care left undone. The higher the competency of nurses (β = 0.26, p < 0.001) and work productivity (β = 0.20, p < 0.001), the higher the nurse-reported quality of care. In addition, nursing care left undone had a negative effect on nurse-reported quality of care (β = -0.15, p < 0.001). Therefore, nursing managers should make efforts to manage team effectiveness in nursing units to improve nurse-reported quality of care.

The Relationship between Psychological Safety and Management Team Effectiveness: The Mediating Role of Behavioral Integration

This study explores whether there is an indirect effect of psychological safety on team effectiveness in management teams, operating through the mediating variable of behavioral integration. Whilst there exists a fair amount of research on the relationship between psychological safety and team effectiveness, few have looked at potential mechanisms that can explain this association in management teams. We propose behavioral integration to be a potential mediator. Data are collected from 1150 leaders in 160 Norwegian management teams, answering a questionnaire measuring team functioning and effectiveness. Team size ranged from 3 to 19 members. Our results show a significant indirect effect of psychological safety on management team effectiveness, mediated by behavioral integration. Thus, the more team members perceive the climate as safe in terms of speaking their mind without the fear of repercussions, the more they partake in mutual collaboration, information sharing and experience ownership in the decisions being made. This is associated with management teams performing better. We also found a positive relationship between psychological safety and behavioral integration, and-in line with previous studies-that psychological safety and behavioral integration both were positively related to team effectiveness. This study adds to the existing team research literature by expanding our knowledge about the importance of psychological safety and the way it influences management team performance at all levels throughout the organizational hierarchy.

Interprofessional Collaboration and Team Effectiveness of Pharmacists in General Practice: A Cross-National Survey

As team-based care continues to evolve, pharmacists have been included in general practice teams in many countries, to varying extents, to improve medication use and patient safety. However, evidence on interprofessional collaboration and team effectiveness of pharmacists in general practice is sparse. This study aimed to compare the extent of interprofessional collaboration and team effectiveness of general practice pharmacists in Australia with international sites (Canada and the UK), and identify the factors associated with interprofessional collaboration and team effectiveness. General practice pharmacists from Australia, Canada, and the UK were identified through professional organisations and networks, and invited to participate in an online survey, adapted from existing validated tools. The survey explored interprofessional collaboration through four sub-domains (professional interactions, relationship initiation, trust and role clarity, and commitment to collaboration) and team effectiveness of general practice pharmacists. Of the 101 respondents (26 from Australia, 44 from Canada and 31 from the UK), 79% were female and 78% were aged below 50 years. Interprofessional collaboration and team effectiveness appeared to be high and similar between countries. Total scores for collaboration of pharmacists were 86.1 ± 7.4 in Australia, 88.5 ± 7.5 in the UK, and 89.1 ± 7.3 in Canada (mean ± SD, where higher scores represent more advanced collaboration), while the team effectiveness scores of the pharmacists were 88.6 ± 14.6 in Canada, 91.8 ± 14.6 in Australia and 97.5 ± 14.0 in the UK. Pharmacists who had worked in general practice for a longer time showed advanced interprofessional collaboration while those who worked exclusively in general practice had higher scores for team effectiveness. Overall, general practice pharmacists in the three countries were highly collaborative with general practitioners. Long-term employment and longer work hours could enhance interprofessional collaboration and team effectiveness in general practice pharmacists by improving trust and working relationships over time.

Increasing Team Effectiveness through Experiential Team Training: An Explanatory Mixed-Methods Study of First-Year Veterinary Students' Team Experiences

This article explores the impact of experiential team communication training on student team effectiveness. First-year veterinary students were concurrently enrolled in the Group Communication in Veterinary Medicine course and applied their knowledge to their authentic team experiences in the Veterinary Anatomy and Introduction to Clinical Problem Solving courses. All students completed a modified team effectiveness instrument and a team self-reflection at the end of the semester. Results show that students experienced a high level of team effectiveness. Although students experienced challenges with respect to staying on task and distributing roles and responsibilities, team coordination and communication improved over time, due in part to the team activities associated with the team training intervention. This research provides support for the impact of experiential team training to the development of team process skills and team effectiveness.

Construction Project Manager's Emotional Intelligence and Team Effectiveness: The Mediating Role of Team Cohesion and the Moderating Effect of Time

The emotional intelligence of a construction project manager plays an essential role in project management, and recent developments in teamwork have increased the need to explore better ways to utilize teams and achieve effectiveness in the construction sector. However, research that holds the team-level perspective in emotional intelligence studies is lacking, and the mechanism of the construction project manager’s emotional intelligence on team effectiveness remains unexplored. This knowledge gap is addressed by developing a model that illuminates how construction project manger’s emotional intelligence can affect team effectiveness via the mediation of team cohesion and the moderation of project team duration. A questionnaire survey was utilized to gather information from construction project teams across 156 leader-member dyads in the Chinese construction industry. The results reveal that construction project manager’s emotional intelligence is positively related to team effectiveness and the team cohesion mediates this cause and effect. Further, project team duration moderates the relationship between team cohesion and effectiveness. This study offers new insight into how project manager can better lead team members toward desired team outcomes from a team perspective and makes an explorative effort in investigating the “time” role in construction project management.

An integrative review and practical guide to team development interventions for translational science teams: One size does not fit all

As the need to tackle complex clinical and societal problems rises, researchers are increasingly taking on a translational approach. This approach, which seeks to integrate theories, methodologies, and frameworks from various disciplines across a team of researchers, places emphasis on translation of findings in order to offer practical solutions to real-world problems. While translational research leads to a number of positive outcomes, there are also a multitude of barriers to conducting effective team science, such as effective coordination and communication across the organizational, disciplinary, and even geographic boundaries of science teams. Given these barriers to success, there is a significant need to establish team interventions that increase science team effectiveness as translational research becomes the new face of science. This review is intended to provide translational scientists with an understanding of barriers to effective team science and equip them with the necessary tools to overcome such barriers. We provide an overview of translational science teams, discuss barriers to science team effectiveness, demonstrate the lacking state of current interventions, and present recommendations for improving interventions in science teams by applying best practices from the teams and groups literature across the four phases of transdisciplinary research.

The Symphony of Team Flow in Virtual Teams. Using Artificial Intelligence for Its Recognition and Promotion

More and more teams are collaborating virtually across the globe, and the COVID-19 pandemic has further encouraged the dissemination of virtual teamwork. However, there are challenges for virtual teams – such as reduced informal communication – with implications for team effectiveness. Team flow is a concept with high potential for promoting team effectiveness, however its measurement and promotion are challenging. Traditional team flow measurements rely on self-report questionnaires that require interrupting the team process. Approaches in artificial intelligence, i.e., machine learning, offer methods to identify an algorithm based on behavioral and sensor data that is able to identify team flow and its dynamics over time without interrupting the process. Thus, in this article we present an approach to identify team flow in virtual teams, using machine learning methods. First of all, based on a literature review, we provide a model of team flow characteristics, composed of characteristics that are shared with individual flow and characteristics that are unique for team flow. It is argued that those characteristics that are unique for team flow are represented by the concept of collective communication. Based on that, we present physiological and behavioral correlates of team flow which are suitable – but not limited to – being assessed in virtual teams and which can be used as input data for a machine learning system to assess team flow in real time. Finally, we suggest interventions to support team flow that can be implemented in real time, in virtual environments and controlled by artificial intelligence. This article thus contributes to finding indicators and dynamics of team flow in virtual teams, to stimulate future research and to promote team effectiveness.

The Dynamic Mechanism on Team Effectiveness in Youth Football: A Chain Mediation

This study aims to deepen our understanding of the relevant research on coach–athlete relationship theory, moral leadership, and team effectiveness theory, and thus explore how to maximize team performance. As such, this study adopts an input-process-output model to explore the effect of coach–athlete relationships on team effectiveness in youth football teams. Participants in this anonymous survey included 312 young athletes, aged 13–19, from professional football schools who filled in questionnaires to provide data on the coach’s moral leadership, team effectiveness, coach–athlete relationships, and trust in the coach. The results indicate that coach–athlete relationships have a significant predictive effect on the moral leadership of coaches, which in turn, has a significant positive correlation with athletes’ trust in coaches; however, coach–athlete relationships have no direct positive correlation with team effectiveness. The coaches’ moral leadership and athletes’ trust in coaches have a chain mediation effect in the impact of coach–athlete relationships on team effectiveness. This study validates the assertion that coach–athlete relationships have a substantial effect on coach leadership. It also refines the coach–athlete relationship theory, provides evidence on the dynamic mechanism in which coach–athlete relationships affect team effectiveness, and enriches team effectiveness theory.

Struggling to Fix Teams in Real Work Settings: A Challenge Assessment and an Intervention Toolbox

After more than 80 years in predicting organizational performance, empirical evidence reveals a science of teams that seems unable to consistently implement solutions for teams performing in real work settings -outside and away from the isolated teams breeding in research laboratories in the academic context. To bridge this growing practitioners-researchers divide, we first identify five main challenges involved in working with teams today (purposeful team staffing; proper task design and allocation; task and interaction process functionality; appropriate affective tone; and suitable team assessment). And second, we offer a toolbox of interventions (empowering and restorative) to help practitioners to transform the potential threats inherent in these challenges into opportunities for team effectiveness. Our five-challenge diagnosis and proposed intervention toolbox contribute to better address research questions and theoretical falsifiability using teams performing in real work settings, and to assess and intervene in teams by adjusting their internal functioning to contextual conditions and constraints.

Teams in Small Organizations: Conceptual, Methodological, and Practical Considerations

Research on teams and teamwork has flourished in the last few decades. Much of what we know about teams and teamwork comes from research using short-term student teams in the lab, teams in larger organizations, and, more recently, teams in rather unique and extreme environments. The context in which teams operate influences team composition, processes, and effectiveness. Small organizations are an understudied and often overlooked context that presents a rich opportunity to augment our understanding of teams and team dynamics. In this paper, we discuss how teams and multi-team systems in small organizations may differ from those found in larger organizations. Many of these differences present both methodological and practical challenges to studying team composition and processes in small complex organizational settings. We advocate for applying and accepting new and less widely used methodological approaches to advance our understanding of the science of teams and teamwork in such contexts.

Core conditions of team effectiveness: Development of a survey measuring Hackman's framework

Leaders and team development practitioners working toward increasing interprofessional team effectiveness frequently need to quickly and accurately determine the extent to which a team possesses the most essential and foundational components required for effective teamwork. While there is no shortage of team theories, there are few freely available, practical, short, and well-developed surveys to measure team functioning across a variety of team types. We developed a 9-item team assessment to fill this gap in the literature, measuring the most fundamental criteria for optimising team functioning, based on Hackman's widely used framework of the foundational conditions for team effectiveness. Reliability and validity of the assessment were investigated through multiple methods, including confirmatory factor analysis and bivariate correlations. Initial psychometric work would appear to support the use of this assessment to measure the three core conditions of team effectiveness. This assessment can be completed by interprofessional team members and their responses can be used to help leaders and team development practitioners focus resources on the most relevant conditions to increase the likelihood of team effectiveness.

Evaluation of General Practice Pharmacists: Study Protocol to Assess Interprofessional Collaboration and Team Effectiveness

The inclusion of pharmacists into general practices has expanded in Australia. However, there is a paucity of research examining interprofessional collaboration and team effectiveness after including a pharmacist into the general practice team in primary or community care. This is a protocol for a cross-national comparative mixed-methods study to (i) investigate interprofessional collaboration and team effectiveness within the general practice team after employing pharmacists in general practices in the Australian Capital Territory (ACT) and (ii) to compare interprofessional collaboration and team effectiveness of pharmacists in general practice across Australia with international sites. The first objective will be addressed through a multiphase sequential explanatory mixed-method design, using surveys and semi-structured interviews. The study will recruit general practice pharmacists, general practitioners, and other health professionals from eight general practices in the ACT. Quantitative and qualitative results will be merged during interpretation to provide complementary perspectives of interprofessional collaboration. Secondly, a quantitative descriptive design will compare findings on interprofessional collaboration (professional interactions, relationship initiation, exchange characteristics, and commitment to collaboration) and team effectiveness of general practice pharmacists in Australia with international sites from Canada and the United Kingdom. The results of the study will be used to provide recommendations on how to best implement the role of general practice pharmacists across Australia.

Shared Leadership and Team Effectiveness: An Investigation of Whether and When in Engineering Design Teams

Shared leadership is lauded to be a performance-enhancing approach with applications in many management domains. It is conceptualized as a dynamic team process as it evolves over time. However, it is surprising to find that there are no studies that have examined its temporally relevant boundary conditions for the effectiveness of the team. Contributing to an advanced understanding of the mechanism of shared leadership in engineering design teams, this research aims to investigate whether shared leadership is positively related to team effectiveness and when shared leadership is more likely to be effective. Using a field sample of 119 individuals in 26 engineering design teams from China and the technique of social network analysis, we found that, consistent with cognate studies, shared leadership is positively related to team effectiveness when measured in terms of team task performance and team viability. Moreover, by integrating the project life cycle as a moderator, this study is among the first to investigate the temporal factors, for the effectiveness of shared leadership. The result shows that the stage of the project life cycle moderates the positive shared leadership-team effectiveness relationship, such that this association is stronger at the early phase than at the later phase of the project. Overall, these findings offer insightful thoughts to scholars in the field of shared leadership and bring practical suggestions for project managers in business who seek to implement best practice in organizations toward high team effectiveness.

The Power of Empowerment: Predictors and Benefits of Shared Leadership in Organizations

Leadership plays an essential part in creating competitive advantage and well-being among employees. One way in which formal leaders can deal with the variety of responsibilities that comes with their role is to share their responsibilities with team members (i.e., shared leadership). Although there is abundant literature on how high-quality peer leadership benefits team effectiveness (TE) and well-being, there is only limited evidence about the underpinning mechanisms of these relationships and how the formal leader can support this process. To address this lacuna, we conducted an online survey study with 146 employees from various organizations. The results suggest that an empowering leadership style of the formal leader is associated with higher perceived peer leadership quality (PLQ) on four different leadership roles (i.e., task, motivational, social, and external leader). In addition, formal leaders who empower their team members are also perceived as better leaders themselves. Moreover, the improved PLQ was in turn positively related to TE and work satisfaction, while being negatively related to burnout. In line with the social identity approach, we found that team identification mediated these relationships. Thus, high-quality peer leaders succeeded in creating a shared sense of “us” in the team, and this team identification in turn generated all the positive outcomes. To conclude, by sharing their lead and empowering the peer leaders in their team, formal leaders are key drivers of the team’s effectiveness, while also enhancing team members’ health and well-being.

How Psychological Safety Affects Team Performance: Mediating Role of Efficacy and Learning Behavior

This article examines the mechanisms that influence team-level performance. It investigates psychological safety, a shared belief that the team is safe for interpersonal risk taking and a causal model mediated by learning behavior and efficacy. This model hypothesizes that psychological safety and efficacy are related, which have been believed to be same-dimension constructs. It also explains the process of how learning behavior affects the team's efficacy. In a study of 104 field sales and service teams in South Korea, psychological safety did not directly affect team effectiveness. However, when mediated by learning behavior and efficacy, a full-mediation effect was found. The results show (i) that psychological safety is the engine of performance, not the fuel, and (ii) how individuals contribute to group performance under a psychologically safe climate, enhancing team processes. Based on the findings, this article suggests theoretical and methodological implications for future research to maximize teams' effectiveness.

Interprofessional/interdisciplinary teamwork during the early COVID-19 pandemic: experience from a children's hospital within an academic health center

The COVID-19 pandemic has created multiple, complex and intense demands on hospitals, including the need for surge planning in the many locations outside epicenters such as northern Italy or New York City. We here describe such surge planning in an Academic Health Center that encompasses a children's hospital. Interprofessional teams from every aspect of inpatient care and hospital operations worked to prepare for a COVID-19 surge. In so doing, they successfully innovated ways to integrate pediatric and adult care and maximize bed capacity. The success of this intense collaborative effort offers an opportunity for ongoing teamwork to enhance efficient, effective, and high-quality patient care.

Leading Teams in the Digital Age: Four Perspectives on Technology and What They Mean for Leading Teams

Digital technologies are changing the nature of teamwork in ways that have important implications for leadership. Though conceptually rich and multi-disciplinary, much of the burgeoning work on technology has not been fully integrated into the leadership literature. To fill this gap, we organize existing work on leadership and technology, outlining four perspectives: (1) technology as context, (2) technology as sociomaterial, (3) technology as creation medium, and (4) technology as teammate. Each technology perspective makes assumptions about how technologies affect teams and the needs for team leadership. Within each perspective, we detail current work on leading teams. This section takes us from virtual teams to new vistas posed by leading online communities, crowds, peer production groups, flash teams, human-robot teams, and human-artificial intelligence teams. We identify 12 leadership implications arising from the ways digital technologies affect organizing. We then leverage our review to identify directions for future leadership research and practice.

Taking a closer look at undergraduate acute care interprofessional simulations: lessons learnt

Interprofessional undergraduate/pre-registration simulations (UIPSims) are growing in popularity but remain under researched and without pedagogic instruction. We report on an evaluation of final year healthcare student UIPSims, focussed on safe practice using a mixed methods study. The evaluation combines traditional methods with direct observations of students. Students completed a pre and post-course questionnaire with scored and free text questions and in addition an ethnographer observed the UIPSims supported with video recordings. Final year students participated (medical, nursing, operating department practitioner, pharmacy; n = 230). The scored questions were significant (p < .01) with student comments confirming the value of the learning. The observations identified strengths and weaknesses. The students were professional and patient-centered, but were unable to function as a team, communicate effectively for shared decision making or recognize and highlight patient safety concerns. The facilitators mainly guided rather than facilitated proceedings. Despite having completed a theme of interprofessional education (IPE) designed to develop team working abilities, final year healthcare students were unable to function as a student team in order to apply theory to practice. The findings highlight how an interprofessional simulation at the end of an undergraduate curriculum offers a litmus test on student readiness for teamworking. The findings support an IPE curriculum with a set of theoretical principles aligned to a set of team working skills in readiness for participating in an UIPSims. In addition, facilitators should be trained on the principles for IPE as well as on best practice for simulations. Briefing is vital, enabling students to come together to form a team and find their collective voice. Observational research offers a powerful evaluation tool illuminating what is happening in these teaching situations. More research on the constituent components of UIPSims is required.

Evaluation of teamwork assessment tools for interprofessional simulation: a systematic literature review

There is growing evidence supporting the use of simulation-based education to improve teamwork in the clinical environment, which results in improved patient outcomes. Interprofessional simulation improves awareness of professional roles and responsibilities, promotes teamwork and provides training in non-technical skills. Tools have been developed to assess the quality of teamwork during simulation, but the use of these tools should be supported by validity evidence in appropriate contexts. This study aims to assess the validity of teamwork tools used in simulation-based interprofessional training for healthcare workers and students, and to compare the design and reporting of these studies. Medline, EMBASE, ERIC, and CINAHL were searched using terms synonymous with simulation, crew resource management, training, assessment, interprofessional, and teamwork, from 2007-2017. Interprofessional healthcare simulation studies involving objectively rated teamwork training were included. The initial search provided 356 records for review, of which 24 were ultimately included. Three tools demonstrated good validity evidence underpinning their use. However, three studies did not explore tool psychometrics at all, and the quality of reporting amongst these studies on design and participant demographics was variable. Further research to generate reporting guidelines and validate existing tools for new populations would be beneficial.

How trust affects performance of interprofessional health-care teams

Interprofessional teamwork in health-care settings is considered a valuable means of enhancing patient management. Literature has highlighted the importance of trust in building effective health-care teams. The present study aimed to investigate and further understand the perceptions of health-care professionals regarding trust and performance within their working team, as well as to assess the association between them and team performance. "TRUST" questionnaire, a valid instrument for measuring the relationship of trust and team performance was distributed to the members of the perioperative teams located in two different hospitals (a University and a General Hospital) in Greece. Two multivariate linear regression models were developed to reveal the significant predictors of high performance per hospital. Among the major findings revealed were 1) trust and performance were closely related 2) slight yet significant variations were observed between the University and the General Hospital and 3) trust level, years of previous experience and number of team members were among the key predictors of effective team performance. This study conveys new knowledge on trust and performance within health-care settings with limited resources and is expected to guide future interventions aiming to enhance team performance.

Fighter pilots' teamwork: a descriptive study

The execution of teamwork varies widely depending on the domain and task in question. Despite the considerable diversity of teams and their operation, researchers tend to aim for unified theories and models regardless of field. However, we argue that there is a need for translation and adaptation of the theoretical models to each specific domain. To this end, a case study was carried out on fighter pilots and it was investigated how teamwork is performed in this specialised and challenging environment, with a specific focus on the dependence on technology for these teams. The collaboration between the fighter pilots is described and analysed using a generic theoretical model for effective teamwork from the literature. The results show that domain-specific application and modification is needed in order for the model to capture fighter pilot's teamwork. The study provides deeper understanding of the working conditions for teams of pilots and gives design implications for how tactical support systems can enhance teamwork in the domain. Practitioner summary: This article presents a qualitative interview study with fighter pilots based on a generic theoretical teamwork model applied to the fighter domain. The purpose is to understand the conditions under which teams of fighter pilots work and to provide guidance for the design of future technological aids.

The Emergence of Group Potency and Its Implications for Team Effectiveness

Much of the previous research on the emergence of team-level constructs has overlooked their inherently dynamic nature by relying on static, cross-sectional approaches. Although theoretical arguments regarding emergent states have underscored the importance of considering time, minimal work has examined the dynamics of emergent states. In the present research, we address this limitation by investigating the dynamic nature of group potency, a crucial emergent state, over time. Theory around the "better-than-average" effect (i.e., an individual's tendency to think he/she is better than the average person) suggests that individuals may have elevated expectations of their group's early potency, but may decrease over time as team members interact gain a more realistic perspective of their group's potential. In addition, as members gain experience with each other, they will develop a shared understanding of their team's attributes. The current study used latent growth and consensus emergence modeling to examine how potency changes over time, and its relation with team effectiveness. Further, in accordance with the input-process-output framework, we investigated how group potency mediated the relations between team-level compositions of conscientiousness and extraversion and team effectiveness. We collected data at three time points throughout an engineering design course from 337 first-year engineering students that comprised 77 project teams. Results indicated that group potency decreased over time in a linear trend, and that group consensus increased over time. We also found that teams' initial potency was a significant predictor of team effectiveness, but that change in potency was not related to team effectiveness. Finally, we found that the indirect effect linking conscientiousness to effectiveness, through initial potency, was supported. Overall, the current study offers a unique understanding of the emergence of group potency, and facilitate a number theoretical and practical implications, which are discussed.

The Conceptualization of Team Flow

Despite the noted potential for team flow to enhance a team's effectiveness, productivity, performance, and capabilities, studies on the construct in the workplace context are scarce. Most research on flow at the group level has been focused on performance in athletics or the arts, and looks at the collective experience. But, the context of work has different parameters, which necessitate a look at individual and team level experiences. In this review, we extend current theories and essay a testable, multilevel model of team flow in the workplace that includes its likely prerequisites, characteristics, and benefits.

Adherence to Oral Anticancer Medications: Evolving Interprofessional Roles and Pharmacist Workforce Considerations

Interprofessional care is exhibited in outpatient oncology practices where practitioners from a myriad of specialties (e.g., oncology, nursing, pharmacy, health informatics and others) work collectively with patients to enhance therapeutic outcomes and minimize adverse effects. Historically, most ambulatory-based anticancer medication therapies have been administrated in infusion clinics or physician offices. Oral anticancer medications (OAMs) have become increasingly prevalent and preferred by patients for use in residential or other non-clinic settings. Self-administration of OAMs represents a significant shift in the management of cancer care and role responsibilities for patients and clinicians. While patients have a greater sense of empowerment and convenience when taking OAMs, adherence is a greater challenge than with intravenous therapies. This paper proposes use of a qualitative systems evaluation, based on theoretical frameworks for interdisciplinary team collaboration and systems science, to examine the social interactionism involved with the use of intravenous anticancer treatments and OAMs (as treatment technologies) by describing patient, organizational, and social systems considerations in communication, care, control, and context (i.e., Kaplan’s 4Cs). This conceptualization can help the healthcare system prepare for substantial workforce changes in cancer management, including increased utilization of oncology pharmacists.

Enhancing the Effectiveness of Work Groups and Teams: A Reflection

Teamwork has been at the core of human accomplishment across the millennia, and it was a focus of social psychological inquiry on small group behavior for nearly half a century. However, as organizations world-wide reorganized work around teams over the past two decades, the nature of teamwork and factors influencing it became a central focus of research in organizational psychology and management. In this article, I reflect on the impetus, strategy, key features, and scientific contribution of "Enhancing the Effectiveness of Work Groups and Teams," by Kozlowski and Ilgen, a review monograph published in Psychological Science in the Public Interest in 2006.

Shared Authentic Leadership in Research Teams: Testing a Multiple Mediation Model

Research teams face complex leadership and coordination challenges. We propose shared authentic leadership (SAL) as a timely approach to addressing these challenges. Drawing from authentic and functional leadership theories, we posit a multiple mediation model that suggests three mechanisms whereby SAL influences team effectiveness: shared mental models (SMM), team trust, and team coordination. To test our hypotheses, we collected survey data on leadership and teamwork within 142 research teams that recently published an article in a peer-reviewed management journal. The results indicate team coordination represents the primary mediating mechanism accounting for the relationship between SAL and research team effectiveness. While teams with high trust and SMM felt more successful and were more satisfied, they were less successful in publishing in high-impact journals. We also found the four SAL dimensions (i.e., self-awareness, relational transparency, balanced processing, and internalized moral perspective) to associate differently with team effectiveness.

How Knowledge Worker Teams Deal Effectively with Task Uncertainty: The Impact of Transformational Leadership and Group Development

The purpose of this paper is to clarify how leadership is able to improve team effectiveness, by means of its influence on group processes (i.e., increasing group development) and on the group task (i.e., decreasing task uncertainty). Four hundred and eight members of 107 teams in a German research and development (R&D) organization completed a web-based survey; they provided measures of transformational leadership, group development, 2 aspects of task uncertainty, task interdependence, and team effectiveness. In 54 of these teams, the leaders answered a web-based survey on team effectiveness. We tested the model with the data from team members, using structural equations modeling. Group development and a task uncertainty measurement that refers to unstable demands from outside the team partially mediate the effect of transformational leadership on team effectiveness in R&D organizations (p < 0.05). Although transformational leaders reduce unclarity of goals (p < 0.05), this seems not to contribute to team effectiveness. The data provided by the leaders was used to assess common source bias, which did not affect the interpretability of the results. Limitations include cross-sectional data and a lower than expected variance of task uncertainty across different job types. This paper contributes to understanding how knowledge worker teams deal effectively with task uncertainty and confirms the importance of group development in this context. This is the first study to examine the effects of transformational leadership and team processes on team effectiveness considering the task characteristics uncertainty and interdependence.

Keys to successful organ procurement: An experience-based review of clinical practices at a high-performing health-care organization

Organ procurement (OP) from donors after brain death and circulatory death represents the primary source of transplanted organs. Despite favorable laws and regulations, OP continues to face challenges for a number of reasons, including institutional, personal, and societal barriers. This focused review presents some of the key components of a successful OP program at a large, high-performing regional health network. This review focuses on effective team approaches, aggressive resuscitative strategies, optimal communication, family support, and community outreach efforts.

Staff perception of interprofessional working relationships after a work redesign intervention in a Danish orthopaedic hand unit outpatient clinic

There is evidence that clinical pathways improve quality of care; however, knowledge is limited concerning the influence on and the benefits experienced by the interprofessional teams working with these pathways. Our working methods in a hand unit in an orthopaedic outpatient clinic in Denmark were redesigned to include, among other changes, the introduction of clinical pathways. Changes included standardising treatment and communication methods, delegating tasks from medical specialists to nurses, and providing nurses with their own consultation room. Using focus group interviews before and after the implementation of the new working methods, we investigated staff-perceived experiences of the effects on working relationships and the utilisation of professional skills and attitudes, resulting from the mentioned change in working methods. The results were changes in daily communication methods among healthcare staff and improvements in the actual communication and collaborative problem solving skills concerning standard patients with simple hand pathology; however, there are still challenges for patients with more complex hand pathology. Though this new interprofessional arrangement improves the use of nurse and medical specialist professional competencies, it also requires a high degree of trust among the team members.

Perceived performance and impact of a non-physician-led interprofessional team in a trauma clinic setting

Faced with the challenge of meeting the wide degree of post-discharge needs in their trauma population, the University of Pittsburgh Medical Center (UPMC) developed a non-physician-led interprofessional team to provide follow-up care at its UPMC Falk Trauma Clinic. We assessed this model of care using a survey to gauge team member perceptions of this model, and used clinic visit documentation to apply a novel approach to assessing how this model improves the care received by clinic patients. The high level of perceived team performance and cohesion suggests that this model has been successful thus far from a provider perspective. Patients are seen most frequently by audiologists, while approximately half of physical therapy and speech language therapy consults generate a new therapy referral, which is interpreted as a potential change in the patient's care trajectory. The broader message of this analysis is that a collaborative, non-hierarchical team model incorporating rehabilitative specialists, who often operate independently of one another, can be successful in this setting, where patients appear to have a strong and previously under-attended need for rehabilitative intervention.

Professional and interprofessional differences in electronic health records use and recognition of safety issues in critically ill patients

During interprofessional intensive care unit (ICU) rounds each member of the interprofessional team is responsible for gathering and interpreting information from the electronic health records (EHR) to facilitate effective team decision-making. This study was conducted to determine how each professional group reviews EHR data in preparation for rounds and their ability to identify patient safety issues. Twenty-five physicians, 29 nurses, and 20 pharmacists participated. Individual participants were given verbal and written sign-out and then asked to review a simulated record in our institution's EHR, which contained 14 patient safety items. After reviewing the chart, subjects presented the patient and the number of safety items recognised was recorded. About 40%, 30%, and 26% of safety issues were recognised by physicians, nurses, and pharmacists, respectively (p = 0.0006) and no item recognised 100% of the time. There was little overlap between the three groups with only 50% of items predicted to be recognised 100% of the time by the team. Differential recognition was associated with marked differences in EHR use, with only 3/152 EHR screens utilised by all three groups and the majority of screens used exclusively only by one group. There were significant and non-overlapping differences in individual profession recognition of patient safety issues in the EHR. Preferential identification of safety issues by certain professional groups may be attributed to differences in EHR use. Future studies will be needed to determine if shared decision-making during rounds can improve recognition of safety issues.

Development and psychometric evaluation of a new team effectiveness scale for all types of community adult mental health teams: a mixed-methods approach

Defining 'effectiveness' in the context of community mental health teams (CMHTs) has become increasingly difficult under the current pattern of provision required in National Health Service mental health services in England. The aim of this study was to establish the characteristics of multi-professional team working effectiveness in adult CMHTs to develop a new measure of CMHT effectiveness. The study was conducted between May and November 2010 and comprised two stages. Stage 1 used a formative evaluative approach based on the Productivity Measurement and Enhancement System to develop the scale with multiple stakeholder groups over a series of qualitative workshops held in various locations across England. Stage 2 analysed responses from a cross-sectional survey of 1500 members in 135 CMHTs from 11 Mental Health Trusts in England to determine the scale's psychometric properties. Based on an analysis of its structural validity and reliability, the resultant 20-item scale demonstrated good psychometric properties and captured one overall latent factor of CMHT effectiveness comprising seven dimensions: improved service user well-being, creative problem-solving, continuous care, inter-team working, respect between professionals, engagement with carers and therapeutic relationships with service users. The scale will be of significant value to CMHTs and healthcare commissioners both nationally and internationally for monitoring, evaluating and improving team functioning in practice.

Processes in healthcare teams that include nurse practitioners: what do patients and families perceive to be effective?

AIMS AND OBJECTIVES

To explore patient and family perceptions of team effectiveness of teams those include nurse practitioners in acute and primary care.

BACKGROUND

Nurse practitioners provide safe and effective care. Patients are satisfied with the care provided by nurse practitioners. Research examining patient and family perceptions of team effectiveness following the implementation of nurse practitioners in teams is lacking.

DESIGN

A descriptive qualitative design was used.

METHODS

We used purposeful sampling to identify participants in four clinical specialties. We collected data from March 2014-January 2015 using semi-structured interviews and demographic questionnaires. Content analysis was used. Descriptive statistics were generated.

RESULTS

Participants (n = 49) believed that the teams were more effective after the implementation of a nurse practitioner and this was important to them. They described processes that teams with nurse practitioners used to effectively provide care. These processes included improved communication, involvement in decision-making, cohesion, care coordination, problem-solving, and a focus on the needs of patients and families. Participants highlighted the importance of interpersonal team dynamics. A human approach, trust, being open to discussion, listening to patient and family concerns and respect were particularly valued by participants. Different processes emerged as priorities when data were examined by speciality. However, communication, trust and taking the time to provide care were the most important processes.

CONCLUSION

The study provides new insights into the views of patients and families and micro-level processes in teams with nurse practitioners. The relative importance of each process varied according to the patient's health condition. Patients and providers identified similar team processes. Future research is needed to identify how team processes influence care outcomes.

RELEVANCE TO CLINICAL PRACTICE

The findings can support patients, clinicians and decision-makers to determine the processes to focus on to promote effective team functioning, and involve patients and families as team members.

Development and validation of the primary care team dynamics survey

OBJECTIVE

To develop and validate a survey instrument designed to measure team dynamics in primary care.

DATA SOURCES/STUDY SETTING

We studied 1,080 physician and nonphysician health care professionals working at 18 primary care practices participating in a learning collaborative aimed at improving team-based care.

STUDY DESIGN

We developed a conceptual model and administered a cross-sectional survey addressing team dynamics, and we assessed reliability and discriminant validity of survey factors and the overall survey's goodness-of-fit using structural equation modeling.

DATA COLLECTION

We administered the survey between September 2012 and March 2013.

PRINCIPAL FINDINGS

Overall response rate was 68 percent (732 respondents). Results support a seven-factor model of team dynamics, suggesting that conditions for team effectiveness, shared understanding, and three supportive processes are associated with acting and feeling like a team and, in turn, perceived team effectiveness. This model demonstrated adequate fit (goodness-of-fit index: 0.91), scale reliability (Cronbach's alphas: 0.71-0.91), and discriminant validity (average factor correlations: 0.49).

CONCLUSIONS

It is possible to measure primary care team dynamics reliably using a 29-item survey. This survey may be used in ambulatory settings to study teamwork and explore the effect of efforts to improve team-based care. Future studies should demonstrate the importance of team dynamics for markers of team effectiveness (e.g., work satisfaction, care quality, clinical outcomes).